Andrea Fernandez1, Elliot Sappey-Marinier2, Frederic Lavoie3, Cécile Batailler2, Elvire Servien2,4, Sébastien Lustig2,5. 1. Emile Gallé Surgical Center, Nancy University Hospital, Nancy, France. a.fernandez@chru-nancy.fr. 2. Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France. 3. Orthopedic Surgery Department, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada. 4. Interuniversity Laboratory of Biology of Mobility, LIBM, EA 7424, Claude Bernard Lyon 1 University, Lyon, France. 5. Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, 69622, Lyon, France.
Abstract
INTRODUCTION: Although bicondylar arthroplasty showed great functional results, it encounters some difficulties to be performed routinely. On the other hand, arthroscopic techniques tend to replace open surgical techniques in sports medicine but strive to be developed in the field of arthroplasty. This study aimed to assess the feasibility of a micro-invasive bi-compartmental knee arthroplasty using both arthroscopic and robotic technologies (A-BiUKA). MATERIALS AND METHODS: The study was conducted on complete fresh-frozen and embalmed cadaveric specimens. The main criterion of judgment was the successful positioning of trial implants through a minimal quad-sparing approach. Arthroscopy was used for bone-morphing and burring, supported by an image-free robotic system. Secondary criteria of judgment were axial deviation (measured using the navigation system), operating time, and incision length. RESULTS: Ten A-BiUKA were performed. Implantation was successful in all cases. The mean preoperative frontal deviation was 179.8° ± 3.2 [175: 185], the mean postoperative frontal deviation was 178.5° ± 2.2 [175: 182], without any outliers. The mean correction was 1.7° ± 1.6 [0: 5]. Once the eight first A-UKA were performed, constituting the learning curve, the mean operative time for the remaining twelves surgeries was 90 min ± 6. The mean skin incision length was 3.35 cm ± 0.13 [3: 4]. CONCLUSION: Associated arthroscopic and robotic technologies allows to perform Bi-UKA procedure using a quad sparing mini-invasive approach. Clinical prospective studies have to confirm the feasibility and the clinical outcomes of this surgery.
INTRODUCTION: Although bicondylar arthroplasty showed great functional results, it encounters some difficulties to be performed routinely. On the other hand, arthroscopic techniques tend to replace open surgical techniques in sports medicine but strive to be developed in the field of arthroplasty. This study aimed to assess the feasibility of a micro-invasive bi-compartmental knee arthroplasty using both arthroscopic and robotic technologies (A-BiUKA). MATERIALS AND METHODS: The study was conducted on complete fresh-frozen and embalmed cadaveric specimens. The main criterion of judgment was the successful positioning of trial implants through a minimal quad-sparing approach. Arthroscopy was used for bone-morphing and burring, supported by an image-free robotic system. Secondary criteria of judgment were axial deviation (measured using the navigation system), operating time, and incision length. RESULTS: Ten A-BiUKA were performed. Implantation was successful in all cases. The mean preoperative frontal deviation was 179.8° ± 3.2 [175: 185], the mean postoperative frontal deviation was 178.5° ± 2.2 [175: 182], without any outliers. The mean correction was 1.7° ± 1.6 [0: 5]. Once the eight first A-UKA were performed, constituting the learning curve, the mean operative time for the remaining twelves surgeries was 90 min ± 6. The mean skin incision length was 3.35 cm ± 0.13 [3: 4]. CONCLUSION: Associated arthroscopic and robotic technologies allows to perform Bi-UKA procedure using a quad sparing mini-invasive approach. Clinical prospective studies have to confirm the feasibility and the clinical outcomes of this surgery.
Authors: E Thienpont; A Vanden Berghe; P E Schwab; J P Forthomme; O Cornu Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-01-06 Impact factor: 4.342